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There are a number of tests that IVF patients have to do prior to IVF treatment. Some of these tests that IVF specialists prescribe to their patients are extremely expensive. Most of these tests are prohibitively expensive and don’t really provide any information that could be useful in diagnosing or treating infertile couples. I recently received this e-mail from a patient. He was looking for IVF treatment. Another IVF clinic had asked him and his wife to do various tests, before going in for a consultation.

For your wife-

AMH

FSH done on day 1 or 2 of menses

TSH

Prolactin

Thyroid peroxidase antibody

Anti-thyroglobulin antibody

Vit D 25 Dihydroxy

Fasting and 2 hours post lunch blood sugar

Karyotype

Trans vaginal pelvic USG between day 10-14 of menses.

For yourself-

Karyotype

Semen analysis

I literally cringed looking at this long list of tests. Not only were some of these tests super-expensive, but most of them wouldn’t provide any information that would be useful in treating infertile couples. Unfortunately, this trend is one that is noticed everywhere and a number of medical specialists tend to ask for excessive tests before they start with the actual treatment.

A waste of time and money

Ideally, the doctors should be talking with their patients, understanding more about the kind of symptoms etc, and they should be using their clinical judgment. Instead, they just order a large number of tests and then channel their efforts on treating certain abnormalities that show up in these test reports, instead of treating the patient. All this over-testing doesn’t help with increasing success rates. It only leads to overtreatment and is an utter waste of time and money.

It is a mathematical certainty that greater the number of tests, larger the number of abnormalities that show up. A lot of these abnormalities have absolutely no bearing on the fertility potential of the couple, as these are found in normal fertile couples as well. However, once an abnormality is found, the doctor is forced to "treat" it! Very few doctors actually make the effort or take the effort to explain to their patients that an abnormal result may be nothing more than a statistical variant and that no clinical significance should be attached to it and that its best to just ignore it.

Patients compound the problem

Unfortunately, patients also tend to contribute to this flood of over-testing. Many patients feel that when their doctors ask them for a large number of tests, they are doing a very thorough job. They feel their doctor is truly an expert who doesn’t leave a single stone unturned in looking for the best treatment option for them. However, more isn’t always better, and patients need to beware of doctors who mindlessly order excessive and expensive tests for all their patients.

Not happy with the attention you are getting from your IVF clinic? Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!